CAMP ATTERBURY, Ind.  The Army has a saying: Train as you fight. Each year, thousands of members of the Joint Task Force  Civil Support converge on Camp Atterbury, Ind., for realistic training during the Vibrant Response exercise hosted by Army North, U.S. Northern Command, the Department of the Army and other inter-governmental agencies.
For both military and civilian participants, it is the years culminating training event, in which a large number of military and civilian agencies work together, testing the nations collective response to a chemical, biological, radiological, nuclear and high-yield explosive disaster.

Surgical Chloe, a full-body surgical simulator, debuted at this years Vibrant Response, as a training force-multiplier for the Armys forward surgical teams. Chloe allows surgeons and medics to test their competencies in medical knowledge, patient care, communication and professionalism.

In medicine, the golden hour is the initial hour following severe trauma or injury, when the patients chances of survival are greatest. For the forward surgical team, whose responsibility in a combat environment is to provide patient stability and hemorrhage control to combat casualties during that golden hour. Chloe represents a leap forward into the future of combat medical training.

Vibrant Response is as good as training gets for all of our organizations working together, said Lt. Col. Kimberlee Aiello, commander of the 56th Multifunctional Medical Battalion, 62nd Med Brigade, Joint Base Lewis-McChord. The scenarios are made as realistic as possible, and each year builds on what weve learned from the past  so each event keeps getting better.

In the past, FSTs have trained largely with question-and-answer style training scenarios and have used mannequins as well as human role-players as the injured patient. Chloe takes this training to new heights.

Not only does Chloe blink and speak, but she also bleeds when shes cut. When surgery is complete, team members are able to suture their way to a proper closing. Chloe is a multi-layered design of skin, muscle, bone, organs, and everything in between, to provide more realism. It has several lifelike abdominal inserts and uterine assemblies, which allow the teams different surgical options. Real surgical instruments are used to perform surgery in an operating room environment.

Team members are able to keep track of how well theyre doing, with a vital signs monitor that continuously shows Chloes progress  or lack thereof. Cameras and voice recorders are integrated at various points and angles to record all that is said and done. These recordings allow the team to assess their performance during scenarios by watching what they did and hearing comments after the fact  an integral part of re-training efforts.
The idea to incorporate the Chloe surgical simulator into the annual Vibrant Response exercise came from an FST member, Maj. Kelly Blair, commander of the 250th FST, 62nd Medical Brigade and a surgeon at Madigan Healthcare System on JBLM.

One of the deficits recognized at prior Vibrant Response (after-action reviews) was that FSTs werent getting a chance to practice any realistic medical simulation, Blair said. Many of them were spending a lot of time setting up tents and tearing them down. I wanted to provide a medical simulation platform to actually train damage control surgery, which we havent done in the Army at all in a simulation environment.

From conception to implementation, Blairs idea of incorporating the Chloe surgical simulator into the Vibrant Response training quickly received a string of blessings, which stretched from 62nd Med Bde. to U.S. Army North Command. Blair, along with subordinate members of the 250th FST, facilitated this years introduction of Chloe.
Our teams skills were definitely put to the test, said Maj. Joshua Paul, commander of 102nd FST, 56th Multifunctional Medical Battalion, 62nd Med Bde. A number of our members have combat experience, but they havent had the opportunity to train in this most realistic manner, with the constraints that are placed on life saving, immediate, far-forward, resuscitative surgery.

In the Vibrant Response training scenario, an FST showed up to support of civil authorities in a disaster management facility or an area hospital  actually a medical simulation training building at Camp Atterbury  whose resources have been overwhelmed.

In training described by Col. Theresa Schneider, commander of the 62nd Med Bde., the FST enters the resource-depleted medical environment and engages with role players, who tell FST members they need military medical help with too few medics and surgeons to care for the casualties in the facility.

The medics triage casualties, provide emergency management stabilization and begin surgery on the Chloe surgical simulator. Once finished, they coordinate for evacuation via ground or air ambulance, completing the mission for that day.

I think Chloe is here to stay, Blair said. All the generals and command team members of Army North that have come through have given it the double-thumbs-up. Weve had an excellent beginning. Next year we want to add a few more simulators, bump up the scenario time limit to give the Soldiers more time to practice and add a few more instructors.